Esophagus
Liver/Gallbladder
Colonoscopy
Cancer
Pancreas
100
Primary medical therapy (and duration of therapy) for GERD without alarm symptoms
Once-daily PPI for 8 weeks (can increase to twice daily for partial response)
100
Primary medical treatment for Primary Biliary Cholangitis
Ursodeoxycholic acid
100
What is the USPSTF Guideline for age to start colonoscopy screens for average risk adults?
45
**On May 18, 2021, the US Preventive Services Task Force (USPSTF) updated its guidance for colorectal cancer screening. In a major change from the previous guidance, the Task Force recommended that adults who are at average risk for colorectal cancer should be screened from age 45 years, rather than from 50 years.
100
What medication is recommended by USPSTF for colon cancer prevention?
aspirin
100
Diagnostic criteria for acute pancreatitis
1.) Clinical symptoms- midepigastric pain w/ radiation to back
2.) Lipase >3 ULN
3.) Radiology findings consistent w/ pancreatitis
200
What is the diagnosis?
Diffuse esophageal spasm/corkscrew esophagus
200
Name the 4 phases of HBV infection
Immune tolerant, immune active, immune control (inactive), reactivation
200
38-year-old healthy man comes to clinic. His personal medical history is unremarkable and he takes no medication. His family history includes colon cancer diagnosed in his father at age 52 years. At what age should he be scoped?
In 2 years; Age 40 years or 10 years earlier than the youngest age at which colon cancer was diagnosed in a first-degree relative, whichever is first.
200
Most common cystic lesions of pancreas
Intraductal papillary mucinous neoplasms (IPMNs)
200
Serology used to identify autoimmune pancreatitis
IgG4
300
Recommended modality to diagnose pseudoachalasia
Endoscopic ultrasonography
(Barium swallow, manometry, endoscopic appearance are similar to achalasia and cannot reliably differentiate)
300
Screening guidelines for HCV
Pts born between 1945 and 1965 require one-time testing for hepatitis C virus.
300
63-year-old woman is evaluated at a follow-up appointment after undergoing right hemicolectomy for colon cancer 1 year earlier. When should they be scoped again?
NOW
Patients who undergo a complete perioperative colonoscopy with clearing of synchronous neoplasia and curative surgical resection for colon cancer should have a subsequent surveillance colonoscopy within 1 year.
300
Abdominal pain, weight loss, (?painless) jaundice
Pancreatic adenocarcinoma
300
Treatment for Chronic Pancreatitis
Low fat, smoking cessation, NSAIDs
400
Treatment for CMV esophagitis
Ganciclovir (IV) or valganciclovir (PO) for 3-6 weeks
400
Preferred treatment for HBV during pregnancy- be specific
TDF- tenofovir disoproxil fumarate
(NOT tenofovir alafenamide)
400
55-year-old woman is evaluated after screening colonoscopy showed three polyps at the rectosigmoid junction. The three polyps were 3 mm, 5 mm, and 6 mm with pathology showing them to be hyperplastic. When should this person have a repeat scope?
10 years.
Patients with small (<10 mm) hyperplastic polyps on baseline colonoscopic examination should undergo surveillance colonoscopy in 10 years. small hyperplastic polyps, often found in the rectosigmoid colon, are believed to have no clinical significance.
400
Name two Hereditary Colorectal Cancer Syndromes.
Lynch
Familial Adenomatous Polyposis (FAP) and Attenuated FAP
MutYH-Associated Polyposis (MAP)
Polymerase Proofreading-Associated Polyposis
Juvenile Polyposis Syndrome
Peutz-Jeghers Syndrome
PTEN Hamartoma Syndrome
400
List 5 causes of acute pancreatitis.
Alcohol, autoimmune, posttraumatic, gallstone, hypertriglyceridemia- induced, idiopathic
500
Level of dysplasia at which endoscopic therapy is recommended for Barrett esophagus?
None - Indefinite - Low-grade - High-grade
Low-grade dysplasia (RFA, endoscopic mucosal resection)
Endoscopic therapy has similar outcomes to esophagectomy in high-grade dysplasia
500
Indications for SBP prophylaxis (name all 3)
1.) Cirrhosis + GIB
2.) Prior episode of SBP
3.) Cirrhosis and ascites w/ ascitic prot <1.5 WITH either liver failure or impaired renal function
3a.) liver failure = CP class B/C and bili >3
3b.) impaired renal function = Cr >1.2, BUN >25, or Na <130
500
An 84 year old patient with Afib, History of CVA, CKD4, and caretaker dependent is given a colonoscopy and two 5mm sessile serrated polyps were found. When should this patient be scoped again?
Never.
This should arguably be this patient’s last scope. The USPSTF recommends that clinicians selectively offer screening for colorectal cancer in adults aged 76 to 85 years. Evidence indicates that the net benefit of screening all persons in this age group is small. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the patient's overall health, prior screening history, and preferences.
500
Upper-endoscopy screening for duodenal cancer in patients with familial adenomatous polyposis (FAP) should begin ___________.
At onset of colonic polyposis or at age 25 to 30 years, whichever comes first.
500
Key imaging findings for autoimmune pancreatitis- Buzz words
Sausage shaped